Location: Left cun, guan, chi, indicate conditions of heart, liver and kidney, cun guan chi of the

right hand indicates lung, spleen and kidney. Three different finger forces: Superficial palpation: slightly Middle palpation: moderately Deep palpation: heavily Differentiation of pulse Depth: superficial or deep Speed: rapid or slow Strength: forceful or weak Shape: thick or thready, soft or weak Rhythm: regular or irregular A normal pulse: is smooth, even and forceful with the frequency of four beats per breath. However, the pulse may vary due to age, sex, body constitution, emotional state and climatic changes. Abnormal pulse 1. Superficial pulse (fu mai) can be easily felt with gentle touch. It indicates exterior syndromes and is present at the early stage of exogenous diseases. It may also be present in prolonged endogenous diseases. In this case, the pulse is superficial, large and weak, indicating outward floating of yang qi. 2. Deep pulse (chen mai) is felt only on heavy pressure. It indicates interior syndromes. Excess: deep and forceful. Deficiency: deep and weak 3. Slow pulse (chi mai) is less than 4 beats per breath. It indicates cold syndromes, qi and blood stagnation. Slow and forceful: interior excess caused by yin cold. Slow and weak: deficiency type due to deficiency of yang qi 4. Rapid pulse (shu mai) is more than 6 beats per breath. It indicates heat syndrome. Excess: rapid forceful. Deficiency: rapid weak. A rapid pulse may also be induced by outward floating of deficiency yang, in this case, it should be rapid, large, weak and empty 5. Pulse of deficiency type (xu mai): forceless pulse, indicates deficiency 6. Pulse of excess type (shi mai): forceful pulse, indicates excess pattern 7. Surging pulse (hong mai): is broad, large and forceful like roaring waves which come on powerfullu and fade away. It indicates excessive heat. 8. Thready pulse (xi mai): feels like a fine thread but is very distinct and clear. It indicates blood and qi deficiency 9. Slippery pulse (hua mai): feels smooth and flowing like pearls rolling on a dish. It indicates phlegm and retained fluids, retention of food and excess heat. Also seen in women during pregnancy 10. Hesitant (se mai): feels rough and uneven. It indicates stagnation of qi, stagnation of blood, impairment of essence and deficiency of blood

11. Wiry pulse (xuan mai): feels taut, straight and long, giving the feeling of string of a violin. It indicates disorders of the liver and gallbladder, painful syndromes and phlegm and retained fluids 12. Tense pulse (jin mai): feels tight and forceful like a stretched rope. It indicates cold, pain and retention of food. 13. Soft pulse (ru mai): a soft pulse is superficial and thready and hits the fingers without strength. Indicates damp disorders 14. Weak pulse (ruo mai): a weak pulse is deep and thready and hits the fingers without strength. Indicates deficiency of both qi and blood 15. abrupt pulse (cu mai): feels hurried and rapid with irregular missed beats. It indicates excessive yang heat, stagnation of qi and blood, and retention of phlegm or food 16. Knotted pulse (jie mai): is slow with irregular missed beats. It indicates excessive yin, accumulation qi, retention of cold phlegm and stagnant blood 17. Regularly intermittent pulse (dai mai): slow and weak with missed beats at a regular intervals. It is associated with declining zang qi, it also indicates wind syndromes, painful syndromes and disorders due to emotional fear and fright, or traumatic contusions and sprains